VALUE ANALYSIS BRIEF

VARIABLE ANGLE LOCKING HAND SYSTEM

Executive Summary

Unmet Clinical Need Variable Angle Locking Hand System Solution:

Tendon adhesion, soft tissue

irritation, and finger stiffness

are common complications

associated with treating hand

fractures.11,13

The VA Locking Hand Plates are pre-contoured, low profile, and have a smooth

surface texture to minimize the risk of soft tissue irritation. Additionally, variable angle

locking technology offers screw placement options in a variety of fragment patterns

around the joint, and screws used with this system were designed with

a blunt tip.

Implant breakage may occur

and require revision surgery

The VA Locking Hand System was designed for construct strength and stability.

Fatigue testing of the VA Locking Hand Plates showed the stainless steel constructs

are stronger than the titanium plates included in the analysis.20 Additional testing

showed the 1.5mm titanium VA Locking Hand Plate construct was stronger than

a larger, thicker 2.0mm non-locking straight plate construct.20

Challenges reported for

post-operative implant

removal include extended

surgical time, excessive blood

loss, debris contamination

and potential refracture.17

In cases where implant removal is required, the smooth surface texture of the VA

Locking Hand Plates may facilitate ease of construct removal. In addition, implant

material may influence ease of removal. As a result, the plates are available in both

stainless steel and titanium providing surgeons with options to address a wide variety

of patient needs.

CLINICAL VALUE

1

Economic Challenge Variable Angle Locking Hand System Solution:

Hospital Standardization In a survey of early users of the VA Locking Hand System, 100% of surgeons stated

they “Strongly Agreed” or “Agreed” that they “would recommend this system to

their colleagues” and 95% of surgeons rated the instruments and overall system as

“Excellent” or “Good”.27

The VA Locking Hand System offers a single system with a versatile range of implant

options providing surgeons with the choices they need to treat a wide variety of

fracture types while promoting hospital standardization strategies.

Operating room efficiency The instrumentation developed for the VA Locking Hand System features design

elements that may streamline the procedure in the operating room potentially

reducing operating room time. The modular cases with color coded instruments and

self-retaining screwdrivers may minimize pain points within the surgical procedure.

ECONOMIC VALUE

2Variable Angle Locking Hand System Value Analysis Brief |

BACKGROUND

Epidemiology Hand fractures are some of the most common orthopedic injuries seen in emergency departments. In 2012,

there were 828,604 emergency room visits for hand fractures in the United States.1 Approximately 42,000

of these patients were subsequently admitted to the same hospital representing about 3.2% of all hospital

patients with a fracture diagnosis.1,2 Approximately 55% of hand fractures occur in the phalanges, 39% in

the metacarpals, and 8% in the carpal bones3 (Figure 1).

FIGURE 1: Fractures of the Hand

Distal

Distal

Middle

Proximal

Proximal

Carpal Bones

Phalanges

Metacarpal Bones

One of the most common fracture sites in the hand is the subcapital region of the fifth metacarpal bone (Boxer’s

Fracture).3 These injuries occur most frequently in young adult men between the ages of 15 and 30 years.5 Most

hand fractures are caused by accidental falls or sports-related injuries.3 Fractures due to sports-related injuries are

more common in the younger population while those resulting from falls are most common in the elderly.3,5

3

Economic BurdenHand fractures impose a substantial economic burden to society due to the direct medical costs of treating hand

fractures as well as the costs of lost productivity and work absenteeism.6 Nearly 1% of all emergency room visits

in the United States are due to hand fractures.5 An analysis of 2012 data from the US Healthcare Cost and

Utilization Project (HCUP) National Inpatient Sample indicates that patients discharged from the hospital with a

hand fracture diagnosis incurred an average cost of $9,204 and an average charge of $33,285.2 Aggregating

these costs nationally to all hospitalized hand fracture patients would imply a societal economic burden in the

US of more than $380 million in direct medical costs.1,2 In Europe, a recent population-based study in the

Netherlands found that hand injuries account for over $278 million in annual costs and lost productivity.7

Clinical BurdenFractures of the hand cause significant disability, negatively impact a patient’s daily and leisure activities, and may

lead to long-term negative functional sequelae, such as the loss of ability to work and live at the pre-injury

level.6,8 More severe hand fractures may sever the blood flow to the bone causing the fracture to heal slowly

(delayed union) or not at all (non-union).9 Early evaluation and appropriate treatment are important in avoiding

complications such as carpal collapse or avascular necrosis.

Restoration of anatomic bony alignment, range of motion, and function are the primary goals for treatment of

hand fractures.5 Although percutaneous K-wire fixation of metacarpal and phalangeal fractures reduction is a

widely used technique because of its technical ease, low cost, and minimal need for dissection, complication

rates as high as 44% have been reported and include pin migration and breakage, loss of reduction and

malunion, pin tract infections, osteomyelitis, injury to nerve and vessels, and nonunion.5,11 Additionally, since

k-wire fixation does not truly provide rigid fixation, a longer period of immobilization may be necessary than

with plating system fixation.12

Plate fixation remains a common method of fixation in hand fractures and has shown to be an effective

technique in enabling stable fixation and early mobilization.13-16 Locking plate technology is most clinically

beneficial for managing osteoporotic fractures, comminuted fractures, fractures with segmental bone loss,

metaphyseal fractures, and intra-articular fractures.5,13 Locking plates are widely considered to provide stronger

fixation compared to non-locking plates.13,21

4Variable Angle Locking Hand System Value Analysis Brief |

PRODUCT DESCRIPTIONThe DePuy Synthes VA Locking Hand System (Figure 2) features a number of design elements which were

developed to deliver clinical and economic value to the hospital, surgeon, and patient. Several of these features

are summarized below:

• Extensive and versatile range of implant options in both stainless steel and titanium,

• Available in 3 locking dimensions:

1.3 mm Locking, 1.5 mm VA Locking, 2.0 mm VA Locking

• Anatomic, low-profile contour and smooth surface texture,

• Stable implant constructs,

• Variable Angle Locking Technology,

• Screw Self Retention, and

• Comprehensive and color-coded instrumentation specific to hand fracture treatment.

FIGURE 2: The DePuy Synthes Variable Angle Locking Hand System

5

METHODS

This value analysis brief presents information on the design features and potential clinical and

economic benefits of using the DePuy Synthes Variable Angle (VA) Locking Hand System for fracture

fixation of the hand. The referenced data for this value brief were obtained through a search of

MEDLINE on the current practice patterns for the management of hand fractures with a focus on

biomechanical and clinical studies of plate fixation published in the last 10 years.

6Variable Angle Locking Hand System Value Analysis Brief |

The VA Locking Hand Plates are pre-contoured, low profile, and have a smooth surface texture

to minimize the risk of soft tissue irritation.

CLINICAL VALUE

Tendon adhesion, soft tissue irritation, and finger stiffness are complications associated with traditional locking

plates for hand fractures.11,13 In cases were treatment of tendon adhesion and stiffness through intensive hand

therapy is not often sufficient and range of motion has plateaued, revision surgery may be necessary.11

The VA Locking Hand System was developed with design features to potentially minimize tendon adhesion and

soft tissue irritation.

Pre-Contoured PlatesThe plates contained within the VA Locking Hand System are pre-contoured to adapt to the bony anatomy. For

example, the phalangeal head plates reflect the natural lateral curve of the phalanges, and the phalangeal base

plates are pre-contoured to match the expanded area of bone in the metaphysis. The system also includes two

plates designed for deformity correction, a Rotation Correction and a Fracture Plate. The Rotation Correction

plate is used to treat a condition in which the fingers are “scissored” or rotated due to a malunion after a

previous injury.

Low-Profile Construct and Smooth Surface TextureThe plates included in the system were designed with low profile, rounded plate edges and a smooth surface to

help reduce the risk of soft tissue irritation. Plate thickness, plate contour, and surface texture are important

factors to consider because tendons must glide over these implants when the fingers move. The screw heads

and plate recesses are also designed to reduce screw prominence following insertion into the plate holes which

may reduce the risk of soft tissue irritation. Figure 3 shows the rounded plate edges and screw heads recessed in

the plate.

FIGURE 3: Low-Profile Construct and Rounded Edges of the VA Locking Hand System

Designed to Reduce Soft Tissue Irritation

7

Additional design features that may minimize soft tissue irritationMany of the plates of the VA Locking Hand System were designed for lateral and dorsal application to help

avoid tendon insertion points and accommodate plate placement need to treat the fracture pattern. Additionally,

variable angle locking technology offers screw placement options needed in a variety of fragment patterns

around the joint, and screws used with this system were designed with a blunt tip.

These design features of the VA Locking Hand System may allow the tendons to slide more freely over the

implant, thereby potentially reducing the risk of soft tissue irritation and tendon stiffness.

While locking plate systems offer a number of advantages in fracture management, their successful use requires

careful preoperative planning, consideration of biomechanical principles (i.e., fatigue strength), and the use of

the appropriate plate and screws combined with good surgical technique.19 Failure to address these issues can

lead to potential complications such as implant breakage or non-union.13 Implant breakage and non-union

frequently require revision surgery.

IMPLANT STRENGTHThe VA Locking Hand System was designed for construct strength and stability. Fatigue testing of the VA

Locking Hand System demonstrates the strength of both the stainless steel and titanium plates offered in this

system. The strength of stainless steel and titanium VA Locking Plates (2.0 mm) was evaluated using fatigue

testing.20 The results show that stainless steel constructs are stronger than titanium constructs for all the VA

Locking Plate types included in the analysis (Figure 4).20

FIGURE 4. Fatigue Testing of 2.0mm VA Locking Plates:

Stainless Steel Constructs Are Stronger Than Titanium20

The strength of the titanium 1.5mm VA Locking First Metacarpal Plate (part of the VA Locking Hand System)

was compared to a stainless steel 2.0mm non-locking straight plate (not part of the VA Locking Hand System).20

The results of this bending test (Figure 5) show the smaller 1.5mm titanium plate of the VA Locking Hand

System is stronger than the larger 2.0mm stainless steel plate of the non-locking plating system.20 These results

show the titanium construct with the smaller screw size (1.5mm) outperforms the stainless steel construct with

the larger screw size (2.0mm).20 It is important to use the smallest screw head size possible to avoid the risk of

splitting the bone and reduce the prominence under the skin when treating hand fractures.29

The VA Locking Hand System was designed to reduce the risk of implant breakage.

40

35

30

25

20

15

10

5

0

New

tons

(N)

Straight Plate

Phalangeal Base Plate

Strut Plate

Fracture Plate

1st Metacarpal Plate

Stainless Steel Titanium

8Variable Angle Locking Hand System Value Analysis Brief |

Variable Angle Locking Technologies Provide Construct StabilityThe 1.5 mm and 2.0 mm implants of the VA Locking Hand System include variable angle locking technology.

The VA locking plate holes are conically threaded with four columns of threads designed to accept variable angle

locking screws in on-axis or off-axis orientations (Figure 6). Standard locking screws may also be inserted at

nominal axis within the VA locking plate holes.

FIGURE 6: The 2.0 mm Variable Angle Locking Plate: Condylar Plate

Variable angle technology allows for variable angle locking screws to be inserted through the plate hole and into

the bone 15° off the central axis of the hole in any direction (i.e. within a 30° cone of angulation off the central

axis). The variable angle locking technology provides fixed angle stability for metaphyseal and osteopenic bone.

The VA Locking Hand System combines the strength of stainless steel and titanium constructs with variable

angle locking technology. The system was designed for construct strength and stability to potentially reduce the

risk of implant breakage.

FIGURE 5. Titanium VA Locking Hand Plate Demonstrating Greater Strength

than a Stainless Steel Straight Plate 20

700

600

500

400

300

200

100

0

Mom

ent

(N-m

m)

Bending Strength

2.0 mm Straight Plate (non-locking, stainless steel)

1.5 mm VA First Metacarpal Plate (dorsal, titanium)

9

Globally, approximately 42% of orthopedic surgeons routinely remove internal fixation devices, such as plates.17

Removal rates range from 5% in the US to 30% in Finland for planned orthopedic procedures.17 In cases where

implants are removed, the ease of removal is important. One of the main causes of implant removal morbidity is

the difficulty in removing the implant due to excessive bony on-growth.17 Difficulties removing fracture fixation

implants due to excessive bony on-growth may result in extended surgical time, excessive blood loss, debris

contamination and potentially refracture.17

Stainless steel (SS) and titanium have different osseointegration and biocompatibility properties.17, 24 An animal

study evaluating the percent bone contact and torque needed to remove screws from plates made of SS and

titanium was published by Hayes et al.17 The sheep were implanted with 4-hole locking compression plates

(Synthes LCP; 51 mm in length, 3.5 mm diameter) with self-tapping, locking head screws (12 mm).17 Materials

included electropolished SS plates with SS screws and “standard” micro-rough commercially pure titanium plates

(cpTi) with standard micro-rough titanium-6% aluminium-7% niobium (TAN) screws. Percent bone contact and

torque for screw removal were measured at 6-, 12-, and 18-months post implantation. The results for 12- and

18-month samples are shown in Table 1.

TABLE 1: Stainless Steel Plate/Screw Constructs Require Less Torque for Screw Removal

and Show Reduced % Bone Contact at 12- and 18-months Post-Implantation than

Titanium Plate/Screw Constructs in an Animal Study17

Torque for Screw Removal (Nm) % Bone Contact

Construct Materials 12 months 18 months 12 months 18 months

SS plate/SS screws 1.2 1.5 34% 10%

cpTi plate/TAN screws 2.2 3.2 52% 65%

Statistical significance p<0.001 p<0.001 p<0.001 p<0.001

SS = stainless steel; cpTi = commercially pure titanium; TAN = titanium-6% aluminium-7% niobium. Data from samples harvested from animals euthanized at 12 months and 18 months post-implantation are shown in table.

The results of the study shown in Table 1 indicate that SS plate and screw constructs require less torque for

screw removal and the percent bone in contact with the plate is less than titanium plate/screw constructs at

12- and 18-months after surgery.17 These results demonstrate that use of stainless steel implants resulted in less

osseointegration than titanium implants.18

Alternatively, titanium has a modulus of elasticity similar to bone, does not cause signal interference with

magnetic resonance imaging, and is considered to be more biocompatible than stainless steel.28 Allergic

reactions to nickel may be present in up to 10% of the population; however, this is not an absolute

contraindication for use of stainless steel implants.28 Titanium screws break more frequently than stainless steel

with attempted extraction, conceivably owing to a lower modulus of elasticity.28

The VA Locking Hand Plates are available in both stainless steel and titanium, and the smooth surface texture

of the plates may facilitate ease of plate removal in cases where plate removal is necessary. Offering the plates

in both stainless steel and titanium provides surgeons with a range of options to address a wide variety of

patient needs.

In cases where implant removal is required, the smooth surface texture of the VA Locking Hand

Plates may facilitate ease of construct removal. Plates are available in both stainless steel and

titanium providing surgeons with options to address a wide variety of patient needs.

10Variable Angle Locking Hand System Value Analysis Brief |

The VA Locking Hand System supports hospital standardization strategies by providing a versatile

range of implant options to meet surgeon preferences and patient needs

ECONOMIC VALUE

Hospital StandardizationStandardization of physician preference items is one method for enhancing a hospital’s supply chain and driving

profitability.22 In addition to cost reduction, standardizing implants can improve efficiency and quality of care.23

Aligning surgeons with hospital cost reduction initiatives, such as standardization of physician preference items,

is an important step in reducing clinical supply spending and creating opportunities for big savings.25 However,

surgeons often develop a strong preference for a specific device or manufacturer creating a challenge for the

hospital to incentivize alignment with standardization strategies that require surgeons to change devices.26

In a survey of 17 early users of the VA Locking Hand System, 100% of surgeons stated they “Strongly Agreed”

or “Agreed” that they “would recommend this system to their colleagues” and 100% of surgeons rated the

overall system as “Excellent” or “Good”.27

These survey results indicate a high level of surgeon satisfaction with the VA Locking Hand System. The strong

willingness to recommend the system is a good indicator of potential surgeon alignment in support of hospital

standardization strategies.

Versatility of the SystemThe VA Locking Hand System offers versatile treatment options for addressing

both simple and complex hand fractures. The plates in the system are provided in

a variety of configurations and sizes to accommodate various fracture types and

patient anatomy. The system consists of 40 different anatomically precontoured

plates including basic plates (Straight, T, & Y Plates), specialty plates (such as

plates designed specifically for the 1st metacarpal), a Metacarpal Neck plate,

curved Phalangeal Head plates, and Web plates. The plates are designed for both

lateral and direct dorsal application to facilitate plate placement and avoid tendon

insertion points. The system contains three plate sizes: 2.0 mm Variable Angle

Locking, 1.5 mm Variable Angle Locking, and 1.3 mm Locking (not Variable

Angle locking). The 1.3 mm plate (Figure 7) is the first 1.3 mm hand locking plate

on the market.4 In addition, all implants are available in both Stainless Steel and

Titanium. The flexibility of the VA Locking Hand System allows the surgeon to

optimize the procedure based on patient need and surgeon preference.

FIGURE 7: 1.3 mm Locking Plate

11

Intuitive orthopedic instruments allow the surgeon and operating room team to focus completely on the patient

and the procedure. The VA Locking Hand System instrumentation features design elements, such as the

modular cases with color coded instruments, self-retaining screwdrivers, ergonomic hex coupling screwdriver

handle, reduction forceps, plate holding forceps, and bending and cutting tools, that may streamline the

procedure in the operating room, potentially reduce operating room time, and minimize pain points within the

surgical procedure.

Comprehensive and Color-Coded InstrumentationThis system includes a series of unique reduction forceps, plate reduction

instrumentation, and cutters to facilitate fracture reduction and further plate

manipulation to adapt to specific patient anatomy, if required. Additionally, the

drill sleeves for reduction forceps, drill bits, screwdrivers, drill guides, and storage

modules are color-coded and correlate to the implant size to be inserted (Figure 8).

This feature aids in the clear identification of instruments for operating room staff

and central processing, and facilitates appropriate instrumentation usage.

Screw Self RetentionThe system includes variable angle locking, locking, and cortex screws which

include either a T4 or T6 STARDRIVETM recess in the screw head. This recess, used

with a STARDRIVE screwdriver, allows the screw to “self-retain” to the driver

(Figure 10), reducing risk of dropped screws and addressing a potential pain point

in the surgical procedure for surgeons and operating room staff.

FIGURE 9: VA Locking Hand System Self-Retaining Driver

The instrumentation of the VA Locking Hand System was designed to facilitate ease of use in the

operating room, which may reduce surgery time.

FIGURE 8: Color-Coded

Instrumentation

CONCLUSIONThe VA Locking Hand System addresses clinical needs for managing hand fractures with its variable angle

locking technology, range of implant options, anatomic contour, low plate profile, smooth plate surface, strong

plate construct, plate availability in both stainless steel and titanium, and comprehensive and color-coded

instrumentation options. These design elements of the VA Locking Hand System were developed to deliver

clinical and economic value to hospitals, surgeons, and patients.

12Variable Angle Locking Hand System Value Analysis Brief |

1. Agency for Healthcare Research and Quality. Nationwide Emergency

Department Sample (NEDS). Based on data for year 2012 using ICD-9

diagnosis codes 814-817 for hand factures. Database accessed at

http://hcupnet.ahrq.gov/; Data run August 2015.

2. Agency for Healthcare Research and Quality. Nationwide Inpatient

Sample (NIS). Based on data for year 2012 using ICD-9 diagnosis

codes 814-817 for hand factures. Database accessed at http://

hcupnet.ahrq.gov/; Data run August 2015.

3. AO Foundation. Hand AO Surgery Reference: Epidemiology of Hand

Fractures. Available at: https://www2.aofoundation.org. Accessed

July 2015.

4. DePuy Synthes. Market analysis of leading orthopaedic companies.

May 2015.

5. Cotterell IH, Richard MJ. Metacarpal and phalangeal fractures in

athletes. Clin Sports Med. 2015 Jan;34(1):69-98.

6. Rosberg HE, Carlsson KS, Cederlund RI, Ramel E, Dahlin LB. Costs and

outcome for serious hand and arm injuries during the first year after

trauma – a prospective study. BMC Public Health. 2013 May

24;13:501.

7. de Putter CE, Selles RW, et al. Economic impact of hand and wrist

injuries: health-care costs and productivity costs in a population-based

study. J Bone Joint Surg Am 2012 2;94:e56.

8. McCarthy C, Samora JB, Awan H. Metacarpal shaft fractures: A

review. OA Orthopaedics 2014 Jun 11;2(2):12.

9. DePuy Synthes. Implant Materials: Unalloyed Titanium (6th Edition) by

John Disegi. November 2008.

10. Doht S, Meffert RH, Raschke MJ, Blunk T, Ochman S. Biomechanical

analysis of the efficacy of locking plates during cyclic loading in

metacarpal fractures. Scientific World Journal. 2014 Mar

13;2014:648787.

11. Gajendran VK, Gajendran VK, Malone KJ. Management of

complications with hand fractures. Hand Clin. 2015 May;31(2):165-

77.

12. Corkum JP, Davison PG, Lalonde DH. Systematic review of the best

evidence in intramedullary fixation for metacarpal fractures. Hand (N

Y). 2013 Sep;8(3):253-60.

13. Fung B, Fok MW. Focus On: New technologies in managing finger

fractures. British Editorial Society of Bone and Joint Surgery. January

2013.

14. Agarwal AK, Pickford MA. Experience with a new ultralow-profile

osteosynthesis system for fractures of the metacarpals and phalanges.

Ann Plast Surg. 2006 Aug;57(2):206-12.

15. Takigami H, Sakano H, Saito T. Internal fixation with the low profile

plate system compared with Kirschner wire fixation: clinical results of

treatment for metacarpal and phalangeal fractures. Hand Surg.

2010;15(1):1-6.

16. Omokawa S, Fujitani R, Dohi Y, Okawa T, Yajima H. Prospective

outcomes of comminuted periarticular metacarpal and phalangeal

fractures treated using a titanium plate system. J Hand Surg Am.

2008 Jul-Aug;33(6):857-63.

17. Hayes JS, Seidenglanz U, Pearce AI, et al. Surface polishing positively

influences ease of plate and screw removal. Eur Cell Mater. 2010;

Feb 26;19:117-26.

18. Plecko M, Sievert C, Andermatt D, et al. Osseointegration and

biocompatibility of different metal implants--a comparative

experimental investigation in sheep. BMC Musculoskelet Disord. 2012

Mar 8;13:32.

19. Nassiri M, MacDonald B, O’Byrne J. Locking compression plate

breakage and fracture non-union: a finite element study of three

patient-specific cases. European Journal of Orthopaedic Surgery &

Traumatology 2012; 22(4):275-281.

20. DePuy Synthes data on file. Technical Report: MT14-108: Fatigue

Testing of Next Generation Hand System VA Locking Plates. May

2014. Project Ref: USTRA10003.

21. Ochman S, Doht S, Paletta J, et al. Comparison between locking and

nonlocking plates for fixation of metacarpal fractures in an animal

model. J Hand Surg Am 2010;35:597-603.

22. Herman B. 11 ways hospitals and health systems can increase

profitability in 2013. 2012, Becker’s Hospital Review.

23. Rodak S, How bundled payments in orthopedics can help build the

foundation for a center of excellence. 2013, Becker Hospital Review.

24. Abdo Bachoura, Ruriko Yoshida, Christian Lattermann, and Srinath

Kamineni, “Late Removal of Titanium Hardware from the Elbow Is

Problematic,” ISRN Orthopedics, vol. 2012, Article ID 256239, 4

pages, 2012.

25. Moran C. Four steps to engage physicians in clinical supply cost

reduction. The Advisory Board: At the Margins. 2015:1-6.

26. Lee J. Losing Preferrential Treatment. 2013. http://www.

modernhealthcare.com/article/20130215/MAGAZINE/302169953.

Accessed 21 March 2015.

27. DePuy Synthes Trauma. data on file. VA Locking Hand System

0000233830: Summary of MPE Results as of 28 September 2015.

28. Yaffe MA, Saucedo JM, Kalainov DM Non-locked and locked plating

technology for hand fractures. Journal of Hand Surgery - American

Volume. 36(12):2052-5, 2011 Dec.

29. Alan E. Freeland, Michael E. Jabaley, James L. Hughes. Stable Fixation

of the Hand and Wrist. 6 December 2012.

REFERENCES

13

DEPUY SYNTHES TRAUMA: FOCUSED ON PATIENTS AND HOSPITALS

Trusted Quality and Innovation

• A century of breakthroughs that create value

Delivering Solutions That Help Improve Clinical Outcomes

• Industry leader in trauma

• Provide a broad, high-quality product portfolio that addresses all your trauma needs

Advanced Technical Support and Training

• Highly-trained, trauma-focused team

• Commitment to education and training

• Industry-leading, customisable education and training programs for entire OR staff

A Clinical Heritage in Plate Technology

Through the years, plate and screw technology has evolved to continually improve

surgical outcomes. DePuy Synthes is an innovator and market leader in plating

technology. Fifteen years ago, DePuy Synthes introduced locking plate technology.

Locking plates represented an important milestone in patient care, merging locking

screw technology with conventional plating techniques.

DePuy Synthes offers a comprehensive range of plate and screw systems to address a

large variety of fracture patterns in the clavicle, humerus, ulna, radius, hand, pelvis,

femur, tibia, fibula, and foot. Since LCP technology was introduced, DePuy Synthes

locking plates have delivered successful clinical outcomes for patients all over the world.

14Variable Angle Locking Hand System Value Analysis Brief |

This publication is not intended for distribution in the USA.

All surgical techniques are available as PDF files at www.depuysynthes.com/ifu

Synthes GmbH Eimattstrasse 3 4436 Oberdorf Switzerland Tel: +41 61 965 61 11 Fax: +41 61 965 66 00 www.depuysynthes.com 0123 ©

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